The potential effect of depression on academic outcomes of students in higher educational institutions of northwest Ethiopia: A cross-sectional study

The purpose of this study was to document potential effect of depression on academic outcomes. We collected a cross sectional data from 710 pre-engineering university students in northwestern part of Ethiopia using cluster sampling. Depressive symptoms were assessed using a locally validated version of Patient Health Questionnaire (PHQ-9) at a cut off 5-9 and 10 or more indicating mild and major depressive symptoms, respectively. The types of substances that students experienced in the last three months were assessed. Multivariable linear regression was carried out to examine whether depressive symptoms predicted academic outcomes (cumulative GPA and perceived difficulties in learning process). Higher PHQ-9 scores were reported by 71.4% (30% mild and 41.4% major levels): of the students. Increment in depression (β=0.296, 95% CI: 0.223, 0.370), anxiety score (β=0.119, 95% CI: 0.011, 0.227), substance use (β=0.169, 95% CI: 0.045, 0.293) and stressful life events (β=0.306, 95% CI: 0.080, 0.532) scores were positively correlated with perceived difficulties in learning. Each increment in self-efficacy score (β=0.006, 95% CI: 0.001, 0.012) was positively associated with semester GPA.  However, PHQ-9 score did not independently associate with semester GPA (β = -0.001, 95% CI:  -0.007, 0.00).  Depressive symptoms were associated with perceived difficulties in learning. Future follow-up studies and intervention strategies are needed to demonstrate causality.   Key words: Depression, academic outcomes, substance use, universities students.